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The many faces of the drug abuse nightmare · Cultural Wars | America Out Loud News

• 0:02
  Good day.
• 0:03
  Welcome to the Midday Report on the American Out Loud News Talk Radio Network.
• 0:08
  The countermomentum of spin.
• 0:09
  I am your host, Dr.
• 0:11
  Franco Musio.
• 0:12
  To our friends listening in the United States and around the world, well, as I mentioned each time now, there's no lack of hard news items to keep our adrenaline going.
• 0:22
  But our aim is to dissect out the nuances and foundations of the vents, the events with which we come into contact continuously.
• 0:33
  So today's show, we're going to step away from the U.S.
• 0:36
  Israeli war against Iran.
• 0:38
  And it's just, my goodness gracious, every hour is continuously developing.
• 0:44
  We're going to focus on another challenge.
• 0:47
  And I'm naming this the many facets, the faces.
• 0:52
  I'm sorry, the many faces of the drug abuse nightmare.
• 0:55
  I'm privileged again to introduce the world's expert on this topic.
• 1:00
  This is our sixth show together.
• 1:02
  Like wine ages, you know, and um, you know, uh it's a gift which keeps on giving.
• 1:09
  In other words, Director Bomb is a gift that keeps on giving, it gets better and better.
• 1:13
  So Richard Baum, he has served at the White House Office of National Drug Control Policy, or ONDCP for two decades in a variety of positions through five presidential administrations.
• 1:26
  He was acting director of ONDCP or drug czar from March 2017 to February 2018 in this position.
• 1:35
  And this was uh with the first Trump administration.
• 1:38
  Uh so he was the first drug czar under President Trump.
• 1:42
  Uh he served as the principal advisor of the president of drug policy and worked directly with cabinet secretaries.
• 1:49
  He he did it all.
• 1:50
  He did it all.
• 1:51
  Um, much of his tenure as acting director, he served concurrently as executive director of the president's commission on combating drug addiction and the opioid crisis.
• 2:01
  So who else who knows knows the subject better than than him?
• 2:04
  So he has served, or he's had uh both degrees, undergraduate and graduate from Georgetown University, my alma mater, as well as master's in public administration from the University of Colorado.
• 2:16
  He is an adjunct professor of public policy, Georgetown's University McCourt Graduate School.
• 2:23
  He told him, I I hope if I were his student, which I guess in a sense I am.
• 2:28
  I hope he's happy with me.
• 2:29
  Um he's come out with a fabulous book.
• 2:32
  It really is fabulous, fabulous, fabulous.
• 2:35
  Inside America's opioid crisis, colon, 12 hard lessons for today's drug war.
• 2:41
  Uh he's had boots on the ground, he's had meetings and working with key household leaders, some friendly to the U.S., some maybe not so much friendly.
• 2:51
  Um this can be purchased at Amazon.com and Bloomsbury Publishing and major retail booksellers or stores.
• 3:01
  So I mentioned before, if you're in the bookstores, you're you're you're waiting, or you've made it.
• 3:06
  And and I'm waiting.
• 3:07
  I'm waiting for his sequel.
• 3:09
  So, Director Baum, welcome again.
• 3:13
  Great to be back and uh really uh look forward to digging more into the book uh and appreciate you reading it and uh so carefully and sharing it.
• 3:20
  Oh my god.
• 3:21
  Uh well, I think it's wonderful.
• 3:23
  Listeners.
• 3:24
  I think it's wonderful.
• 3:25
  So your experience uh and uh and your book.
• 3:28
  So metaphorically, it's like an onion, but but the layers do not end.
• 3:32
  So you have 12 chapters, but each chapter is a springboard for so much more.
• 3:37
  And we're gonna piggyback onto our last show.
• 3:40
  And uh our last show, we were taking excerpts from uh uh one chapter mainly, chapter nine.
• 3:48
  I'm gonna do that again, the ones we didn't cover in chapter 11 and a few other things.
• 3:53
  And and I'm gonna, this is like a softball.
• 3:55
  It's a softball because you wrote it.
• 3:57
  You actually wrote it.
• 3:59
  But I want you to hit as hard as you can in turn in terms of the response to me.
• 4:05
  So chapter nine, uh, very appropriately uh called defense in depth, smart border security and international supply control for today's synthetic drug era.
• 4:16
  So um, and then you have subchapters as well.
• 4:20
  So let me just get into the meat here.
• 4:22
  Uh, and I'm gonna quote you.
• 4:23
  I'm gonna quote you.
• 4:25
  So if seizures double from year to year, and then the first time when I see seizures, I think in a medical sense, you know, somebody seizing.
• 4:32
  No, what you meant was that the border uh officers seizing drugs.
• 4:37
  Uh so if seizures double from year to year, it should not be interpreted as a sign of success.
• 4:42
  Our agents don't get twice as good from one year to the next.
• 4:46
  Uh major increases in methamphetamine seizures are a telltale sign that there was a far higher total volume of drugs.
• 4:55
  That's the key word, total volume of drugs being manufactured and getting into our country.
• 5:02
  So, there, I'll give you the softball.
• 5:06
  Uh well, you know, I'm a big fan of uh uh the the classic buck seven habits of highly effective people.
• 5:13
  Uh and uh and I think you know, one of the things to keep in mind, I think it's Habit 3 is keep the end in mind.
• 5:22
  And the end in mind in drug interdiction is to disrupt dismantle and otherwise undermine the ability of these drug cartels to operate.
• 5:34
  So a seizure is a means to an end.
• 5:36
  It helps tell us uh about the traffickers.
• 5:40
  It tells them how they're moving drugs, what they're moving, who they're using to move it, and you want to turn every seizure that you can into an investigation, hopefully it'll lead to a control delivery and an informant.
• 5:55
  I mean, don't get me wrong.
• 5:56
  I'm always happy when illegal drugs get off the street.
• 5:59
  But you know, the the trafficker can replace the drug product.
• 6:03
  Yeah, yeah.
• 6:04
  But what you really want to do is figure out the key operatives, the key safe houses, the guys who handle the money, the leadership.
• 6:12
  And so we should think of seizures as uh as a means to an end to understand and disrupt and dismantle the cartels and realize that they're not a great success.
• 6:24
  I mean, it's a product of a fantastic work by our agents who deserve respect for for what they've accomplished.
• 6:31
  But in terms of the larger goal, uh that's disrupting the whole cartels.
• 6:36
  And uh so I I mean, I don't criticize uh DEA or CBP to want to uh show a photos of large seizures that they make, stack it all up and be proud of the accomplishment.
• 6:48
  That's perfectly understandable uh for the uh uh the the work product, right?
• 6:54
  Of their of their great work.
• 6:55
  But the real work product, you can't be put uh stacked up on a table.
• 7:00
  It's the dismantling of the cartels.
• 7:02
  So I'm gonna keep on going here, particularly about methamphetamines.
• 7:06
  You wrote here in 2004, there were 23,929 methamphetamine lab incidents and uh dump sites found in the U.S.
• 7:17
  by U.S.
• 7:17
  law enforcement.
• 7:18
  By 2014, the number of lab sites dropped to below 10,000 and then continue to fall.
• 7:24
  Uh that represents an important victory for U.S.
• 7:26
  drug enforcement.
• 7:28
  But as the tighter per purchase and per month limits kicked in, especially in some of the early acting states like Oregon, who made pseudo uh pseudophedrin prescriptions only, and the number of small toxic lab sites drop like a rock.
• 7:43
  So you go further to say so for those readers who wonder why in many states cold medications are behind the pharmacy counter, now you have the answer.
• 7:51
  Every time one of my kids caught a cold, my wife got annoyed at me, yet again, for the extra time we had to stand uh on a line at the pharmacy to buy the product.
• 8:01
  But the strategy of restricting pseudophedrin, uh the access worked.
• 8:06
  My colleagues and I in the federal, state, and local governments that supported the restrictions, are proud of this accomplishments and made our country safer by the reducing the number of small user labs that became toxic water sites after the meth was produced.
• 8:19
  Uh then you said uh for a time the new restrictions also seemed to drive down meth consumption in the United States.
• 8:27
  Unfortunately, it didn't last.
• 8:31
  Yeah.
• 8:32
  Well, you know, uh it was a big accomplishment because we don't want meth labs in our uh neighborhoods, suburbs, rural areas, because somebody can happen uh on them or somebody could um you know uh uh sell uh sell a home and you can't see it by looking at it, but there couldn't be these chemical, you know, uh damaging fumes.
• 8:54
  So uh we don't want methamphetamine manufactured in the U.S.
• 8:59
  And it was a hard problem.
• 9:01
  It was a very hard problem all over the country.
• 9:03
  There would be small toxic labs, people would go to uh to a Home Depot or another store, buy the supplies, get the pseudohedron, or steal it from a drugstore and manufacture meth uh all around the country.
• 9:16
  And the fact that it got pushed out of the U.S.
• 9:18
  was good.
• 9:19
  But I'm just trying to be straight with everybody.
• 9:22
  I I wish it was a permanent victory.
• 9:24
  It wasn't.
• 9:24
  It was progress in making the country safer and progress for a time and driving down meth production and consumption, but the drug market did recover, and now again we face uh very high uh volume and high potency uh methamphetamine coming into the U.S.
• 9:42
  produced by Mexican cartels.
• 9:44
  So uh them the facts, just trying to be straight.
• 9:47
  So that dovetails into another excerpt here.
• 9:50
  You said as it happens in the drug business, the market adapted to successful controls.
• 9:54
  Production shifted to Mexico.
• 9:56
  Mexican traffickers now produce methamphetamine on a large scale.
• 10:00
  At low cost and high purity.
• 10:02
  They and their business partners inside the United States are working to expand the meth market, moving beyond traditional areas to use in the Western United States to target the East Coast.
• 10:12
  Methamphetamine moves across the southwest border, just like heroin and cocaine in hidden vehicular compartments as well as via commercial uh shipping by truck, train, boat, and air.
• 10:23
  Further, it's not just white powder that our agents are looking for when searching for meth.
• 10:28
  Traffickers can only or can also liquefy methamphetamine and smuggle it in gas tanks or bottles, disrupting the methamphetamine supplies even tougher to stop than cocaine or heroin.
• 10:41
  Another option is trying to find out, find and destroy the uh the labs inside Mexico.
• 10:47
  So, yeah, it it's like a moving target.
• 10:49
  It just it morphs, it evolves, it morphs.
• 10:52
  You know, you you cut off a head and a different head, you know, comes up.
• 10:58
  It's crazy.
• 11:00
  It is a very tough problem.
• 11:02
  Uh, and you know, I try and be uh careful and there aren't like live easy solutions.
• 11:08
  However, uh the today, the Mexican cartels uh who manufacture methamphetamine do rely on precursor chemicals, uh primarily from China.
• 11:20
  Uh and those chemicals, it's a little bit different than the market for um for um fentanyl or uh prescription opioid, uh sorry, not prescription, uh just for um synthetic opioids.
• 11:31
  Yeah, uh because the uh the precursor, some of them are dual use.
• 11:36
  Um however, um uh I do believe that the uh the world, the UN could do a better job scheduling and controlling the pre these precursor chemicals.
• 11:48
  And as you know, as we talked about in earlier podcast, I've called for a new synthetic drug treaty that would provide more authority from the UN and the international narcotics control board to control these precursors, because you know, okay, something can be a dual-use chemical, but also these companies should know that if uh if uh uh the they have a Mexico Mexican importer uh trying to get you know 20 times uh amount, 20 times the amount they they got a few years earlier.
• 12:18
  It's a red flag.
• 12:19
  It's a big red flag.
• 12:20
  Yeah, they should know their customer.
• 12:23
  There needs to be a higher responsibility on these companies, on the shippers to know their customer.
• 12:30
  Uh so I'm not saying it's easy, but if you're looking at how what the center of gravity is to attack the methamphetamine supply chain, it is like synthetic opioids, it's the precursor chemicals, they're coming out of Asia, and we need to do a better job focusing on how to disrupt that trade.
• 12:48
  How about how about the uh the phrase uh money is the root of all evil?
• 12:54
  So if money were that's true enough.
• 12:58
  If Monty were not if money were not behind this.
• 13:00
  All right, here's one.
• 13:01
  The scope of Mexican drug traffickers' operations within the United States is vast, and they are adept at expanding distributions to reach new users.
• 13:09
  Their tactics, not just for methamphetamines, but for other drugs as well, include providing free samples.
• 13:15
  That's crazy, like at a physician's office, my office, um, targeting areas near drug treatment centers and embedding operatives inside communities to build an informal friends and family network to reach more potential drug consumers.
• 13:30
  It's like the massad from from Israel or the CIA and having uh covert, extremely covert operations, but very deliberate and and very crafty.
• 13:42
  Uh that kills so to speak.
• 13:45
  It's a good analogy, but you know, they are a corporation looking for customers, and uh they know that um you know, uh near treatment centers, uh they they'll find people that with a history of drug use, uh, and they'll just um, you know, they're they're they're flexible.
• 14:04
  They'll they do trial and error, they do market research, and they see uh what what works, and they have a product that have has an instant uh effect on people that uh at least for the short term uh shows some benefits, right?
• 14:19
  And then over time, uh that consequence uh uh builds up and then it damages uh people's ability to lead the lives they want to lead.
• 14:27
  But short term, uh a lot of people find methamphetamine appealing, especially when it's so cheap, available, and potent.
• 14:35
  So where where do they publish this uh this research?
• 14:39
  And you said that they do like the Pew Center or or uh Well, um, you know, some of the I'm kidding, it's illicit and it's illicit that they don't publish it, but that's what I do.
• 14:51
  No, oh, I see the traffickers.
• 14:53
  Yeah, well, I mean, there's good there there are there are good journalist accounts and academic accounts and interviews with people who use drugs that collectively give us a pretty decent picture of the of the drug market.
• 15:06
  Of course, you have to be very humble because just when you think you understand how uh drug market works, uh it evolves, right?
• 15:13
  The use patterns evolved, the products evolved.
• 15:17
  So uh what we knew two or three years ago may change.
• 15:22
  That's why I'm an advocate for doing very regular uh focus groups and surveys with people who use drugs and those who work with them, because we in the public health and public safety side need that very current data in order to understand what we're dealing with.
• 15:38
  The market research.
• 15:39
  So I'm gonna I'm gonna flip pages and go to fentanyl and go to the synthetic and semi-synthetic opioids, because that's a huge, huge issue.
• 15:49
  And I'm gonna read a little bit, and then on the flip side, uh we only have a couple minutes left of this segment, but your your sub-segment, the global battle to disrupt the fentanyl supply chain from China.
• 16:01
  And I'm gonna add possibly India as well.
• 16:04
  Um so let's start with that.
• 16:07
  Is it only China and Asia?
• 16:09
  Or uh I I guess India is part of Asia, but you have to go more east.
• 16:14
  I I mean, I I think it's it's important to mention uh that there are other possible suppliers, but it's China still dominates the Chinese uh chemical companies.
• 16:25
  However, uh you know, these uh these drug cartels, they don't want to be dependent on uh on one country to supply or only a small set of chemical companies.
• 16:36
  They want multiple suppliers, just like if you're manufacturing cars, right?
• 16:40
  You want to have uh you need airbags, right?
• 16:43
  You don't you don't want to only have one supplier.
• 16:45
  So uh they they do try and diversify.
• 16:48
  Right now, uh yeah, India is uh is not a major share, but because they have such a large industry, they have the potential to uh replace uh um some of the Chinese suppliers if and when the Chinese government is able to get them more than out of the business.
• 17:06
  So I'm gonna hard stop you there, Director Bro.
• 17:09
  Uh I guess like diversity, like uh like having our portfolio to diversify it as well.
• 17:14
  So uh on the flip side, uh we're gonna stop for a commercial blake break, but uh on the other side, we're gonna go into fentanyl in depth.
• 17:22
  Thank you.
• 17:22
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• 19:19
  And welcome back.
• 19:21
  So we're gonna we're gonna speak about this is gonna be an extra that uh and this is hitting on what you were mentioning before.
• 19:30
  So quote uh it's hard to believe how quickly drug markets have changed.
• 19:35
  But before 2013, fentanyl barely showed up as a significant cause of fatal drug overdoses.
• 19:42
  By 2016, it was the number one cause of drug overdoses in the United States, uh, topping 20,000.
• 19:50
  As of this writing, so this was just a couple years ago or a year ago, uh, there are just under 80,000 estimated total uh fatal overdoses per the previous.
• 20:00
  Previous 12 months for which data is available, with almost 44,000 involving synthetic opioids such as fentanyl.
• 20:07
  This dramatic escalation between 2013 and today is very unusual in the drug business and quite scary.
• 20:13
  The interdiction challenge is also scary.
• 20:16
  Catching these small shipments among the over 10,000 small packages that come through JFK each day makes the Southwest border uh challenge look interesting.
• 20:28
  So what say you still coming across the JFK?
• 20:32
  Uh it it it does come directly uh by the mail, but not as frequently as it did uh a few years ago.
• 20:40
  It's mostly coming across the border, and it is an enormous challenge uh because just the um the way uh the the methodology of the traffickers of breaking up these shipments into um small packages, a kilo or two secreted in a car uh or carried on a person or on a train, you know.
• 21:02
  So it's um it's a challenge.
• 21:04
  There isn't like a little lever we have where we can turn some methodology on and stop you know 90% of the of the fentanyl.
• 21:12
  It's it's very tough, uh, which is why um the the chemical precursors are uh are so critical.
• 21:18
  Uh go sort of that's the that's the version of going to the source in the case of synthetic opioids.
• 21:24
  So you wrote here, unfortunately, all kinds of people in the United States were ordering fentanyl from China on their smartphones or computers for delivery to their homes or a P.O.
• 21:32
  box in the United States.
• 21:34
  Some were individual consumers, others were professional drug dealers, perhaps trying to break into an extremely lucrative business for the first time.
• 21:42
  Uh and then you went on still, after a lot of brilliant work by U.S.
• 21:46
  uh agencies and you uh and a good bit of progress, good bit of progress has been made in reducing the threat from fentanyl in the international mail.
• 21:54
  Controlling this mail flow of fentanyl in the United States has to a significant degree been accomplished due to major law enforcement and diplomatic efforts.
• 22:02
  Uh and a couple more here, the Chinese government banned at U.S.
• 22:06
  and international urging, I gather the UN too.
• 22:09
  Many of the synthetic opioids that were being trans shipped directly to the United States.
• 22:14
  This was important progress.
• 22:16
  Unfortunately, the significant tactical success did not lead to endurance success at the strategic level.
• 22:22
  Rather than small shipments of finished fentanyl coming directly from China, the precursor chemicals needed to manufacture fentanyl are now trans shipped to Mexico, as you were mentioning.
• 22:34
  So Mexican traffickers finished the manufacturing and are now the major source for most of the supply of synthetic opioids into the United States.
• 22:41
  So can we not spearhead, Rich or Director Baum, efforts to completely destroy the labs in Mexico, just like we're bombing strategically and with laser guided uh laser guided missiles in Iran as we speak.
• 22:55
  Can we do that with the labs?
• 22:58
  Or to the labels, that's it.
• 23:00
  Dr.
• 23:00
  Lucio, you know, I uh I'm definitely for uh the kitchen sink strategy.
• 23:05
  I'm for doing everything we can do to limit mitigate damage the cartels, learn about their operations.
• 23:13
  So that does include uh finding out where the labs are uh in Mexico and working with the Mexican government to uh to um hopefully uh you know raid them, capture the cooks and the operatives uh of not to just to destroy them.
• 23:29
  So I'm for that.
• 23:30
  I'm also you know for uh the interdiction on the border, uh, but I think that like still the the critical aspect is what happens in the the in the countries and the companies that produce these precursors.
• 23:44
  And you know, uh I let me just take a quick sec to explain that I I think you one has heard if you read a read the drug policy news over the years, you hear a lot of very tough rhetoric from people who uh like myself and others who've been in these senior positions criticizing the Chinese government because we want them to do more.
• 24:03
  We feel like they we know they can do more uh to control.
• 24:08
  However, it's not that but they have done some things, and they have uh banned a good number of these chemicals at U.S.
• 24:16
  urging, even though they don't have uh in their domestic population the same type of problem.
• 24:23
  They have a heroin problem, but not really a fentanyl misuse problem.
• 24:27
  So, you know, the relationship runs a little hot and cold, uh uh probably an understatement there, but we have gotten some uh diplomatic concessions from the Chinese to ban some of these chemicals, and we need to keep the pressure on uh both uh you know privately and publicly, uh bilaterally, regionally, internationally, to push the Chinese to continue to take this threat seriously.
• 24:50
  Spoken like a statesman, true statesman.
• 24:52
  So I didn't know that heroin was an issue.
• 24:54
  Now, for the audience and for myself too, I'm gonna give everyone a quick pharmacology lesson before continuing, because I I think it's it's key.
• 25:03
  So we have three different substances, if you will.
• 25:06
  We have natural opioids, such as derived uh directly from the opium poppy plant, and those are morphine, codeine, um theabane.
• 25:17
  I remember theobane, the hospital, and opium itself.
• 25:20
  So those are natural opioids.
• 25:23
  Again, derived directly from the plant, the opium poppy plant.
• 25:26
  Then we have semi-synthetic opioids.
• 25:30
  So that this is the jargon that I think is important to understand.
• 25:34
  The semi-synthetic uh opioids, they're made in a laboratory by chemically processing the natural opioids.
• 25:42
  So, for example, oxycodone, hydrocodone, the prescription narcotics, uh, hydromorphone, uh, oxymorphone, and and the non-prescription, the illicit heroin, all of these are semi-synthetic, again, made in a laboratory by chemical processing of the natural.
• 25:59
  Then we have the synthetic.
• 26:02
  And this is what we're talking about, mainly the the uh they require precursor chemicals because, for example, uh synthetic opioids, they're manufactured entirely from chemical ingredients rather than being refined from natural sources.
• 26:17
  Well, we like we just said, the opium poppy so that uh poppy, they're they're created through multi-step chemical reactions.
• 26:24
  So fentanyl and it's analogs, but it gets very complex.
• 26:28
  So the fentanyl is about 50 to 100 times uh commonly used in the uh anesthesia setting, 100 50 to 100 times more potent than morphine, and and then there's analogs.
• 26:38
  It like I said, it gets very um very complex.
• 26:42
  You have carved fentanyl, that the mainly for better air use, acetylfentanyl and butyryl fentanyl, these are all chemical modifications.
• 26:50
  You have methadone, these are synthetic opioids, tramadol, these are legal, these are licit, not illicit, but then you have uh nitazines, nitizes.
• 27:03
  They're very potent class of synthetic opioids.
• 27:06
  Again, they need precursor chemicals, and then there's variations of the nitizes.
• 27:11
  You have other chemicals that just have numbers, like U4, 7, 7, 0, 0, I don't know if you recall that Director Baum, like pink, where it's called pink or U4 uh it's on the illicit market.
• 27:27
  And then you got carfentanyl we talked about, all these um all these different combinations that are just mind-boggling.
• 27:35
  But to go to one of what you said, one of one of another experts, you wrote here, as Vanda Felba Brown rightly observed in her study China and synthetic drug control, the structural quote, characteristics of synthetic drugs, including the ease of developing similar but not scheduled synthetic drugs and their new precursors, pose immense structural obstacles to controlling supply, irrespective of political will to prohibit and regulate their use and enforce the regulations.
• 28:08
  So I talked a lot there, but you know, we're we're learning more and more and more, and and for sure the cartels have chemists.
• 28:17
  I mean, you don't produce these without PhDs in chemistry who know what they're doing.
• 28:24
  Uh you know, um uh Dr.
• 28:26
  Mizio, uh let me let me uh uh add on to a couple things.
• 28:30
  Uh first off, yes, they have chemists, but they're really cooks, they're trying to recruit higher level chemists so they can figure out how to manufacture the precursors themselves, which is a lot harder than just cooking fentanyl from the precursors.
• 28:45
  I also I think uh it's important for me to highlight that there uh uh there's evidence that there's been over the last year or two, two years, something of a fentanyl drought uh because of uh for multiple reasons, but primarily because that China schedule banned some of these key precursors.
• 29:07
  Uh, that's and uh and so uh a lot of us in the field uh believe that uh a can that this lower concentration of fentanyl, sort of fewer chocolate chips in the chocolate chip cookie because traffickers have a hard time getting the highest quality fentanyl precursors, so they're making less uh they're putting less of the fentanyl in the powders and pills they sell.
• 29:34
  And we think that that has contributed to lower overdoses, uh although you know there are a lot of factors, so I think that's kind of oversimplify.
• 29:43
  So that's been happening, but and that's good.
• 29:45
  And that that that's a success.
• 29:47
  That's like a diplomatic success for the U.S.
• 29:50
  uh and others uh that we should be pleased with.
• 29:53
  However, we should recognize that we're uh when we're combating the cartels here, we're at
• 30:00
  With they're a very clever, resourceful foe.
• 30:03
  So they will be looking and are looking to replace uh uh that volume of high quality precursors uh and will find uh you know it's hard to predict exactly how long, but you can be sure that they will uh find a way to increase that supply.
• 30:21
  Uh so uh I I'm I'm I'm glad I'm happy that the overdoses are down and the fentanyl concentration is down.
• 30:29
  I hope it stays down as long as possible.
• 30:31
  It gives people who are uh using drugs, it reduces their risk and gives them more opportunity to get into treatment.
• 30:37
  Uh but uh we should uh brace ourselves for the fentanyl supply to recover.
• 30:43
  So let me well, that dovetails into this.
• 30:46
  Let me let me read this to you.
• 30:48
  So, what's particularly troubling about the phenomenon of synthetic opioids is that drug traffickers and street dealers are now not just mixing fentanyl into heroin, they are reaching a larger market by utilizing fentanyl and maybe the lower quality fentanyl to manufacture fraudulent prescription drugs and adding it to cocaine and methamphetamine packets for retail sale.
• 31:10
  Although traffickers and drug dealers are killing many of their customers, there is a cruel economic logic to these tactics.
• 31:17
  Traffickers are adding fentanyl to more of their drug product line to further increase the intensity of the high and the addictive potential of these substances, creating many more repeat customers each day.
• 31:30
  So that's incredible.
• 31:31
  And I gather too, and you said in uh in a subsequent chapter that fentanyl um can also be added to counterfeit pills like opioids and benzodiazepines like Xanax and Valium as well.
• 31:43
  So just to finish, this approach is particularly dangerous for drug consumers buying cocaine or methamphetamines who may be opioid naive.
• 31:52
  Um, yeah, uh we clearly need both supply and demand reduction efforts and well, I'll leave it at that.
• 31:59
  But um, you're saying the quality or the potency may be a little less, but still, if you give it to fentanyl naive or narcotic naive individuals, and you're selling, you know, uh non-prescript or counterfeit prescription, Xanax and Valium and other substances, it could be just as deadly.
• 32:20
  Yeah, absolutely.
• 32:21
  And uh and we should keep in mind that even though overdoses are down, uh, maybe down to around 70,000 a year uh pace over the last 12 months, and that is uh, you know, a big decline from about 110,000 peak in 2022, but it's still way above historical levels when um 25 years ago we would only have seven or eight thousand total doses a year.
• 32:43
  So A, it's still very, very high.
• 32:46
  That's a lot of Americans, right?
• 32:47
  That's a football stadium full of Americans dying each year.
• 32:50
  Uh so very serious.
• 32:52
  And also, as as you were explaining, the fact that people are are using buying and using uh uh synthetic synthetic opioids and stimulants together, uh that's a top addiction, right?
• 33:07
  You've got to treat both you gotta co-treat both of those addictions, and uh, you know, in a way it's simpler if you're just on an opioid, uh, because you could get someone on uh uh bubinorphine, a methamphetamine, um, bubenorphine or uh or uh methadone and um in and you know focus on getting them uh into recovery, but now you also got to worry about the methamphetamine and cocaine.
• 33:31
  Uh and so that's a problem.
• 33:33
  And also, you know, some people are using these two drugs like stimulants and and uh and uh opioids together intentionally, and others are not, right?
• 33:43
  So people very, I don't want to generalize because if you if you're um some people, if you say if you're on the street and you're homeless, you might consume methamphetamine at night and uh opioids during the day, because you know it's safer for you to be awake so you don't get robbed or attacked.
• 34:00
  Uh so there's a that's a complexity in here, but what we do know uh in summary is the drug supply is still very dangerous, it continues to change, it has many substances in it, and there's still a very severe risk of uh addiction and overdose.
• 34:15
  Yeah.
• 34:15
  Well, I'm gonna I'm gonna turn the page here to chapter 11, your chapter 11.
• 34:19
  To me, the way you interpret chapter 11, it's a fentanyl generation protecting youth from today's dangerous drug threats.
• 34:26
  And I look at it as a social science foundation.
• 34:29
  It's absolutely wonderful what you wrote here.
• 34:33
  And and clearly, this is a springboard as well to oh, goodness gracious social science.
• 34:39
  So I'm gonna introduce it with this.
• 34:41
  This is what you you wrote straight talk for dangerous times.
• 34:44
  I don't believe in scare tactics.
• 34:46
  The research on drug prevention clearly shows that it is not effective with adolescents.
• 34:51
  Telling them something is going to destroy their lives or kill them conflicts with conflicts with their sense of autonomy.
• 34:57
  A fair understanding of prevention science is to avoid scaremongering as ineffective.
• 35:03
  The risk profile for young people are exposed to today is in fact severe and life-threatening.
• 35:10
  We must work very hard to find ways to deliver that message effectively to teenagers and not assume that what messages are compelling for adults are effective with adolescents.
• 35:21
  Um experience, uh experience during elementary and medical school, middle school, not medical school, middle school can set kids on a problematic trajectory in terms of risky behavior, including but not limited to substance misuse.
• 35:35
  That that really resonated with me.
• 35:36
  That that was just a wonderful introduction.
• 35:39
  To me, it also spoke of the brain development of youngsters that their brains are not fully developed.
• 35:46
  Uh teenagers are not.
• 35:48
  I think they say in your mid-20s or late 20s or even early 30s is when your brain is fully developed.
• 35:54
  Part of that is experience, of course, as well and wisdom.
• 35:58
  Um, so it goes hand in hand.
• 36:00
  But yeah, you lay it out very, very nicely there.
• 36:04
  Well, uh, you know, thank you.
• 36:05
  I I it this is a reality.
• 36:08
  We need our young people, and I'm talking now about grade school kids.
• 36:13
  They need the skills to be resilient.
• 36:17
  Uh we need uh professionals, you know, uh seeing these kids in the school, and and if somebody has emerging behavioral health issues uh or um dental health challenges or difficulties, complexity in the home, whatever it is, so much better to intervene when they're young when they're 10 or 11 and not when they're 16 or 17, right so that they get more benefit of their schooling.
• 36:44
  So and it's also cheaper, you know, because the uh the interventions cost less, there's no criminal justice involvement.
• 36:51
  So I think it just the reality is we owe it to our kids to be more resolute on uh and helping to identify problems earlier and getting help.
• 37:02
  Because if we're waiting until they're 16 or 17, we're really missing these windows of development to uh make kids more resilient.
• 37:10
  I would argue with you that it's even earlier.
• 37:12
  You had mentioned what uh uh 1112 or so, 10, 11, 12.
• 37:16
  I I would argue even much earlier than that in terms of age.
• 37:19
  Well, I'm gonna stop you there, and we're gonna pick up the ball here right after commercial break time goes by very quickly.
• 37:26
  And we're gonna continue to talk about the human the social science aspect of this.
• 37:32
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• 40:14
  We are back.
• 40:16
  Thank you.
• 40:17
  Thank you for holding on everyone.
• 40:18
  So we're back with Director Baum and speaking about the social sciences and the true, true, true life and reality here.
• 40:27
  Director Baum, I'm going to read some other excerpts here.
• 40:29
  The uh quote the threat posed by the wide variety of fraudulent prescription pills containing fentanyl, marketed to young people via the internet, poses a moral, a mortal, mortal risk to this generation of young people.
• 40:42
  All the generations to follow will likely face the same or perhaps even a more serious threat.
• 40:48
  So I would interject here.
• 40:50
  What about the drug internet culture?
• 40:51
  So not only fentanyl or other drugs.
• 40:54
  So for example, you you can't drive at almost any time during the day, but especially the morning and afternoon and put on a radio in the car and ED, erectile dysfunction, it goes on and on and on.
• 41:06
  You know, you know, go on the internet and you can do this and you can do that for these new combinations for erectile dysfunction and many others.
• 41:14
  So mass media is clearly contributing to this.
• 41:18
  Well, I I think that uh we're used to all of us are used to ordering things on the internet.
• 41:25
  Something we want, we go on the website or an app and we order it.
• 41:30
  And uh that's just the way the life is today.
• 41:33
  But when it comes to some something you're gonna put in your body of some medication, especially if it's a prescription drug medication, or you think it's a prescription drug medication, you can't cut corners.
• 41:46
  No.
• 41:47
  You just have to, uh, we uh moms and dads and the teachers and nurses have to say, absolutely, you need a medication, we want you to get it.
• 41:55
  See the nurse, talk to your parents, go see a doctor, but never, never, never order some prescription drug on the internet from an app or take it from a friend.
• 42:05
  Because your friend may say, Oh my God, you're not sleeping.
• 42:08
  Uh, I want to share with you one of my Xanaxes, which they shouldn't do because it's illegal, but people do it.
• 42:14
  But your friend might have ordered it on the internet and not gotten the real thing.
• 42:19
  And unfortunately, it's too risky.
• 42:21
  There's there's there, um, there are a lot of these fraudulent pills going around.
• 42:25
  So I uh we've we we really just need to get that message out to train young people.
• 42:30
  Hey, you need a medication that is totally fine.
• 42:33
  Come on in, you'll get a prescription, you go to a real pharmacy, no shortcuts.
• 42:38
  Guess what?
• 42:38
  Guess what, Director Baum, the adults have this problem too.
• 42:42
  You know, adults do this.
• 42:43
  So it's not only children, but adults.
• 42:46
  I've seen it in my practice.
• 42:47
  And you know, such and such.
• 42:49
  Oh my God.
• 42:50
  Yeah, they're it's true to all it's true to all of us, you know.
• 42:53
  Um, and I'm just I I guess I'm most fearful for those people that are like in high school or college.
• 42:59
  Sure.
• 42:59
  And uh, and you know, uh, you know, like like all of us, but especially young people, any kid, even the best kids can have a bad night, a breakup, uh an all-nighter, you know, something just something happens during the day, you know, uh, whatever, a bad test.
• 43:16
  And like they can want to reach for something to feel better, and we all can understand that.
• 43:21
  Sure.
• 43:21
  But today, you know, you just can't.
• 43:24
  You just have to be more careful.
• 43:25
  No.
• 43:26
  So speaking to that, quote, but it's also true that in this world of youthful activity and energy, some kids are also struggling.
• 43:34
  Recognizing who needs help is not always easy.
• 43:38
  Uh rather, many of these kids have a quote, life problem, end of quote.
• 43:42
  Uh, and they are utilizing drugs or alcohol to self-medicate as a coping mechanism to deal with stress, anxiety, or depression.
• 43:49
  Youthful experimentation, not inevitably, but often enough leads to bigger trouble down the road.
• 43:56
  Identifying underage substance use or other behavioral health issues should be a priority in schools.
• 44:02
  It's not always easy to find those who need help and guide them back on their track before serious consequences mount.
• 44:08
  But the investment in time and resources to intervene early is well worth it.
• 44:12
  Delay can be costly uh in more ways than one.
• 44:17
  So do you think, and I don't know the right answer.
• 44:22
  Has life become more complicated?
• 44:24
  Uh is it more complex now than before?
• 44:28
  Uh well, clearly mass media, yeah, mass media, social media has made it in my opinion, much, much more complex.
• 44:35
  And you add the drug cartels and the power they have on top of mass media and and what's going on with our culture.
• 44:42
  This is different than what it was even 20 years ago.
• 44:46
  You know, you know, I I I like that.
• 44:48
  I mean, it's it's well known now about the smartphones and the internet, but it is true, you know, if uh if you do something, if you're a kid and you say something or do something that embarrasses you, maybe in when you and I were kids, uh, just our immediate friends or friends or friends would know that, like 10 people.
• 45:05
  Now, you know, someone captures it on video and they tell the whole world, and people are mortified.
• 45:11
  Uh, and so I think we are living in a complicated world, and people are comparing themselves to each other.
• 45:18
  Uh, and um, you know, and and there there are challenges.
• 45:22
  And I would also I would wanted to I wanted to highlight in my book because I I I know this.
• 45:26
  Like I'm an anti-drug guy.
• 45:27
  So when I with drugs are, no, you know, I went into schools, right?
• 45:32
  I'm talking about the drug problem.
• 45:33
  Yes, you know, and so I really want people to say, oh my God, I think I'm um I'm 13 or 14, and I I think I have a drug problem.
• 45:41
  But people don't go around in their head, uh, go around and say, oh my God, I have a drug problem.
• 45:46
  No, they've got some other problem that and the drugs that maybe become a part of the drugs or alcohol.
• 45:52
  And so I think those of us who are specialists in certain areas have to like take a step back and say, hey, whatever it is, if somebody is having some type of problem and they're turning to substances or unhealthy practices uh or behavior, uh, we want to recognize it.
• 46:09
  And the drugs are only one um unhelpful way that people try and cope with stuff, but there are others, and uh that's why I just feel like the return on investment.
• 46:18
  You know, I'm sensitive about uh proposing spending more money and uh for states and federal government, but man, you you you help people when they're young and you set them on track.
• 46:29
  It's gonna cost us a society so much less.
• 46:32
  Uh and the risks are there, we need to make the investments and get people help early.
• 46:37
  Yep, yep.
• 46:38
  Well said.
• 46:39
  Well said.
• 46:40
  So you here's another one.
• 46:42
  Um rather, they're going through their busy high school lives with school family responsibilities, work parties, friends, and romantic relationships, and dealing with the normal teenagers' emotional ups and downs.
• 46:54
  Uh, and then there's more.
• 46:56
  There's further many other students had uh of these students, I guess, had a parent or guardian who had developed a serious substance misuse problem or had become involved with the justice system.
• 47:08
  Too often they told me you were recounting uh going to different schools and speaking with people yourself.
• 47:14
  Too often they told me even young people who had shown great academic promise ended up dropping out uh to care for a family member or to work to support them.
• 47:23
  Some of their students were among the estimated 321,566 children nationwide who lost their mom or dad from a fatal drug overdose between 2011, 2021.
• 47:38
  Uh a recent study found that nationwide, almost one in four children, a total of 19 million were living in a household with a parent with a substance use disorder.
• 47:48
  So, in terms of nature nurture, we'll talk about that in a minute.
• 47:52
  Uh the nurture part being the what they learn from their environment and their core core family, uh transfers to many of these kids, unfortunately.
• 48:06
  You know, it's very hard.
• 48:08
  Um if you're a kid trying to navigate the world, seven or eight, nine, ten, and there's something going on at home where um mom and mom or dad of the guardian or the stepdad or stepmom, they are having some trouble in their lives.
• 48:24
  Uh and that destabilizes um the household for the young person and uh and takes away kind of from the routine that uh makes people feel safe.
• 48:35
  Uh and uh sometimes uh young people need help dealing with that, and sometimes families need counseling or or advice uh to make sure everyone's safe.
• 48:45
  Uh and when and in this example I'm talking about in the book that you quoted, I was referring to a school I went to in Johnstown, Pennsylvania, uh and uh how sometimes these uh like teenage kids uh in high school had a drop out because they needed to work to take care of their family because mom or dad um whatever got arrested or wasn't able to work.
• 49:07
  So even if the kid is basically okay, uh sometimes these responsibilities to either work or to take care of a mom or dad uh intrude on their development.
• 49:18
  So we have to recognize some people have these complicated uh life problems, and if you're a young person, you shouldn't be on your own trying to navigate these hurdles.
• 49:27
  Yeah, it's not fair.
• 49:29
  Life isn't fair, you know, the old adage, and and it's really, really true.
• 49:33
  Um, so here's one.
• 49:34
  Um it's under the subheading ensuring the drug prevention programs work to drive down drug use.
• 49:40
  He wrote, as described in a comprehensive report by the partnership to end addiction, quote, it is becoming increasingly clear that the seeds of addiction risk and resilience uh are planted very early in life.
• 49:53
  Of course, that's what we've been talking about, necessitating a shift in the traditional approach to substance use prevention.
• 49:59
  We now know.
• 50:00
  That experience uh experiences in infancy and early to middle childhood, coupled with biological and larger social vulnerabilities, set the stage for how children will fare as they age.
• 50:12
  Even small interventions can successfully shift the course of risk for a child.
• 50:17
  By intervening earlier and more broadly, we can prevent substance use and its negative consequences.
• 50:23
  And yeah, this is what you've been advocating time and time again.
• 50:27
  Here's another one.
• 50:28
  So upstream efforts aim to prevent those problems from happening, as uh Dan Heath explains in his book on this topic.
• 50:38
  Downstream work can be more tangible.
• 50:40
  It reflects a reaction to a problem right in front of us.
• 50:44
  Upstream successes are less visible.
• 50:46
  Quote, you'll never know who you help.
• 50:49
  Your victories are written in data, um, uh staring invisible heroes who save invisible victims, end of quote.
• 50:56
  Nonetheless, the payoff is dramatic.
• 50:58
  So this is more uh the prevention is key in what you've been talking about.
• 51:03
  It's similar to chronic diseases, and which I deal with all the time.
• 51:07
  Chronic diseases, um, many times, many times, and this is what the current administration is working with Health and Human Services is intervening early to help stop getting to the chronic disease break uh phase and proactive versus reactive.
• 51:23
  If you're reactive, that's clearly not as good as proactive.
• 51:28
  Uh meaning you're not going to be as fruitful with reactive versus proactive.
• 51:33
  You know, uh we want our our leaders, our politicians, we want them to produce results, measurable results, and we want them to do it quickly, and that's that's normal.
• 51:42
  That's good, right?
• 51:43
  We want to hold them accountable.
• 51:44
  Yeah.
• 51:45
  But a lot of these things on building resilience in young people, the results come in eight to ten years.
• 51:53
  So I just reality is those investments cost less and benefit more.
• 51:59
  But we've got to show collectively the sort of the political willingness to say, you know what, even though I'm not going to see this benefit for a decade in my community in my state and the country, that's what's worth it because it's better.
• 52:13
  It's better for them and it's better for us as a society.
• 52:16
  But we've made this decision.
• 52:18
  We collectively in the U.S., we decided not to fully fund uh what it takes to uh protect young people.
• 52:27
  And I just think the world is too dangerous, and we gotta we've got to invest now wisely because over the long run it costs a lot less.
• 52:35
  So the analogy I'm thinking of right now is ridding Iran of a nuclear weapons or the ability to make nuclear weapons, right?
• 52:42
  So that's very preemptive, if you will, although some would argue, no, they're they're they're you know way on the road to doing that, but we intervened at the right time.
• 52:52
  There's a difference there.
• 52:54
  Nuclear weapons are very different, but nuclear weapons kills kill and kill many, many, many people, but so do drugs.
• 53:03
  So is there is there a huge difference between intervening with drugs uh or drug use versus intervening with nuclear weapons?
• 53:12
  Because I would argue, I would argue not as a true conservative, but you know, both are lethal.
• 53:19
  Well, in different ways.
• 53:20
  In different ways.
• 53:22
  If we can head off problems before they're right in our face, we'll all be better off.
• 53:27
  And you know, in the book, um, going back to um the international narcotics issues, uh, I wish that there were we could snap our fingers or do something over a couple months and get rid of the Mexican cartels and uh you know stop these poisons from coming into our country.
• 53:43
  I I would do it.
• 53:44
  I mean, I I would love to do that, but and I I want to do everything we can to harm them, to disrupt their activities, but I think we also need to invest long term in building up the uh capacity of the Mexican government uh to work with us more effectively.
• 54:01
  So that's training uh and uh ensuring that that they uh they have the expertise to do operations, to do investigation, to do intelligence.
• 54:11
  Um and so we need to put in uh over time, and hopefully they'll be more capable and they won't need to rely on us or others to um to police uh these cartels.
• 54:22
  Um, and over time they'll uh make a better society for Mexico, but but also for us.
• 54:27
  So, you know, we can do both.
• 54:29
  I'm not saying no, do nothing about the immediate problem and just focus on 10 years in the future.
• 54:34
  I think we can uh we can do both.
• 54:35
  It's just uh, you know, you you you you you spread uh your investment on some of the short-term goals and some of the long-term goals.
• 54:43
  Yeah, you dealt a lot with, of course, policy issues.
• 54:46
  You dealt a lot with funding, you but you were dealing with the hundreds and hundreds of millions of dollars.
• 54:51
  And and this is not easy.
• 54:53
  And you get into politics, of course, Congress uh to vote to get approved, and different administrations will focus on different things and and volume of money.
• 55:04
  So this is not easy.
• 55:06
  Okay, here, I I love this.
• 55:08
  Further, it's important to keep in mind the need to ensure children develop this resilience before they gain control of their own smartphones.
• 55:15
  Jonathan Hayde in his 2024 book, The Anxious Generation makes the case that frequent use of smartphones and social media by young adolescents is causing harm.
• 55:27
  Well, that's for sure.
• 55:28
  He reports that by 2022, 46% of adolescents were online almost constantly, and notes that Gen Z is the first generation to have, quote, gone through puberty, hunched over smartphones and tablets, having fewer face-to-face conversations and shoulder-to-shoulder adventures with their friends, end of quote.
• 55:48
  These experiences are occurring at a critical time, quote, when the brain is more vulnerable to the effects of sustained stressors, which can tilt the adolescent in a mental disorder, such as generalizing anxiety disorder, depression, eating disorders, and substance abuse, end of quote.
• 56:06
  This he explains makes adolescents both the time to risk uh a time of risk, but also a window of opportunity for advancing adolescents' health and well-being.
• 56:15
  It's a formative opportunity that families, communities, and the country don't want to miss.
• 56:21
  So thank you so much for listening.
• 56:23
  I enthusiastically look forward to being with you weekly on the countermomentum of spin, where we will endeavor to address and work towards solving the problems of the world.
• 56:33
  Uh, please note that the show and all the shows on America Out Loud Talk Radio go to your favorite podcast network within 24 hours, Apple Podcasts, Spotify, Pandora, TuneIn, Amazon, BiPart Radio, and among others.
• 56:47
  Have a great day.
• 56:48
  God bless you.